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https://www.readbyqxmd.com/read/28099056/multidisciplinary-approach-to-esophageal-achalasia-a-single-center-experience
#1
Francisco Schlottmann, Ciro Andolfi, Robert T Kavitt, Vani J A Konda, Marco G Patti
BACKGROUND: The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. MATERIALS AND METHODS: A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28095262/biosimilars-in-inflammatory-bowel-disease-accumulating-clinical-evidence
#2
Sean McConachie, Sheila M Wilhelm, Pramodini B Kale-Pradhan
Biologic antagonists to tumor necrosis factor alpha (TNF- α) are effective medications and have become well established in the treatment of both Crohn's disease and ulcerative colitis. Biosimilar medications, which are medications deemed to be equivalent to reference biologic products in terms of clinical effectiveness, safety, pharmacokinetic analysis, and immunogenicity, have now been approved in inflammatory bowel diseases (IBD) based on indication exploration from clinical data in alternate disease states...
January 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28094313/comparison-of-symptoms-healthcare-utilization-and-treatment-in-diagnosed-and-undiagnosed-individuals-with-diarrhea-predominant-irritable-bowel-syndrome
#3
Gregory S Sayuk, Ray Wolf, Lin Chang
OBJECTIVES: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by symptoms including abdominal pain and altered bowel function. Up to 75% of individuals with IBS may be undiagnosed. The aim of this study was to characterize symptoms, healthcare utilization, and treatments in populations with both diagnosed and undiagnosed IBS. METHODS: An online survey was conducted to compare gastrointestinal (GI) symptoms, healthcare visits, well-being, symptom management, and treatment satisfaction in individuals with and without medically diagnosed IBS (Rome III criteria)...
January 17, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#4
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28088179/chronic-constipation-diagnosis-and-treatment-evaluation-the-chro-co-di-t-e-study
#5
Massimo Bellini, Paolo Usai-Satta, Antonio Bove, Renato Bocchini, Francesca Galeazzi, Edda Battaglia, Pietro Alduini, Elisabetta Buscarini, Gabrio Bassotti
BACKGROUND: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. METHODS: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires...
January 14, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#6
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#7
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28079621/effects-of-education-and-information-on-vaccination-behavior-in-patients-with-inflammatory-bowel-disease
#8
Sofie Coenen, Ellen Weyts, Cedric Jorissen, Paul De Munter, Maja Noman, Vera Ballet, Séverine Vermeire, Gert Van Assche, Marc Ferrante
BACKGROUND: Despite the existence of international guidelines, vaccination in patients with inflammatory bowel disease (IBD) has not been integrated optimally. We developed a thorough education program, and compared its influence on vaccination rates with routine clinical practice in a tertiary IBD center. METHODS: Between December 2014 and March 2015, we included 505 consecutive patients with IBD visiting our outpatient clinic (53% men, 72% Crohn's disease, median age 44 years)...
January 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28079347/the-diagnostic-challenge-of-symptomatic-uncomplicated-diverticular-disease
#9
Cesare Cremon, Lara Bellacosa, Maria R Barbaro, Rosanna F Cogliandro, Vincenzo Stanghellini, Giovanni Barbara
Colonic diverticulosis is a common condition in Western industrialized countries occurring in up to 65% of people over the age of 60 years. Only a minority of these subjects (about 10- 25%) experience symptoms, fulfilling Rome criteria for irritable bowel syndrome (IBS) diagnosis (IBS-like symptoms) in 10 to 66% of cases. Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms attributed to diverticula in the absence of macroscopically evident alterations other than the presence of diverticula...
January 12, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28072736/von-hippel-lindau-disease-involving-pancreas-and-biliary-system-a-rare-case-report
#10
Xu-Ting Zhi, Qi-Yu Bo, Feng Zhao, Dong Sun, Tao Li
RATIONALE: Von Hippel-Lindau (VHL) disease is a rare inherited, autosomal-dominant syndrome caused by heterozygous germline mutations in the VHL gene. VHL patients are prone to develop benign and malignant tumors and cysts in multiple organ systems involving kidneys, pancreas and central nervous system (CNS). The varied and complex clinical manifestations and radiological findings of VHL are of interest. PATIENT CONCERNS: We report a 38-year-old woman with a ten-year history of VHL disease involving both pancreas and biliary system...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071656/acg-clinical-guideline-preventive-care-in-inflammatory-bowel-disease
#11
Francis A Farraye, Gil Y Melmed, Gary R Lichtenstein, Sunanda V Kane
Recent data suggest that inflammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy...
January 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28069898/is-visual-radiological-evaluation-of-liver-tumour-burden-in-patients-with-neuroendocrine-tumours-reproducible
#12
Magaly Zappa, Olivia Hentic, Marie-Pierre Vullierme, Matthieu Lagadec, Maxime Ronot, Philippe Ruszniewski, Valérie Vilgrain
Background Visual semi-quantitative assessment of liver tumour burden for neuroendocrine tumour liver metastases is often used in patient management and outcome. However, published data on the reproducibility of these evaluations are lacking. Objective The aim of this study was to evaluate the inter and intraobserver agreement of a visual semi-quantitative assessment of liver tumour burden using CT scan. Methods Fifty consecutive patients (24 men and 26 women, mean age 54 years old) were retrospectively reviewed by four readers (two senior radiologists, one junior radiologist and one gastroenterologist) who assessed the liver tumour burden based on visual a semi-quantitative method with four classes (0-10%, 11-25%, 26-50%, and ≥50%)...
January 9, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28061975/the-place-of-stress-and-emotions-in-the-irritable-bowel-syndrome
#13
S Pellissier, B Bonaz
Our emotional state can have many consequences on our somatic health and well-being. Negative emotions such as anxiety play a major role in gut functioning due to the bidirectional communications between gut and brain, namely, the brain-gut axis. The irritable bowel syndrome (IBS), characterized by an unusual visceral hypersensitivity, is the most common disorder encountered by gastroenterologists. Among the main symptoms, the presence of current or recurrent abdominal pain or discomfort associated with bloating and altered bowel habits characterizes this syndrome that could strongly alter the quality of life...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28056484/-biosimilars-in-inflammatory-bowel-disease-ibd-experiences-and-perceptions-of-german-gastroenterologists
#14
Bernd Bokemeyer, Axel Dignaß, Stefan Schreiber
The European Medicines Agency (EMA) recently approved the first anti-TNF-alpha biosimilar for infliximab (CT-P13) (trade names: Inflectra(®) and Remsima(®)) in Germany. Over the past year, German gastroenterologists gained experience treating IBD-patients with infliximab biosimilars (IFX-biosimilars). To evaluate their experiences and opinions on biosimilars, we conducted a nationwide online survey among German gastroenterologists. Our results are based on the assessment of 449 questionnaires. Although 61 % of the participants had already prescribed IFX-biosimilars, about two thirds of these participating gastroenterologists with IFX-biosimilar prescription stated their experience as based on fewer than 10 IBD-patients treated with IFX-biosimilars...
January 5, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28045200/quality-of-colonoscopy-performed-in-rural-practice-experience-from-the-clinical-outcomes-research-initiative-and-the-oregon-rural-practice-based-research-network
#15
Jennifer L Holub, Cynthia Morris, Lyle J Fagnan, Judith R Logan, LeAnn C Michaels, David A Lieberman
PURPOSE: Colon cancer screening is effective. To complete screening in 80% of individuals over age 50 years by 2018 will require adequate colonoscopy capacity throughout the country, including rural areas, where colonoscopy providers may have less specialized training. Our aim was to study the quality of colonoscopy in rural settings. METHODS: The Clinical Outcomes Research Initiative (CORI) and the Oregon Rural Practice-based Research Network (ORPRN) collaborated to recruit Oregon rural practices to submit colonoscopy reports to CORI's National Endoscopic Database (NED)...
January 3, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28042391/identification-of-factors-associated-with-sedation-tolerance-in-5000-patients-undergoing-outpatient-colonoscopy-canadian-tertiary-center-experience
#16
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
AIM: To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. METHODS: A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28005258/pancreatic-cancer-management-and-treatment-landscape-awareness-of-gastroenterologists-results-from-us-physician-surveys-conducted-in-2013-and-2015
#17
Gregory D Salinas, Lee Whitworth, Patti Merwin, Joan Emarine
INTRODUCTION: In the US, gastroenterologists (GIs) often inform patients of the initial diagnosis of pancreatic cancer. Thus, GIs are frequently the first physicians to provide vital information regarding treatment strategies and options to patients which can have significant impact on subsequent clinical decision-making. Since treatments for pancreatic cancer are rapidly evolving, it may be challenging for GIs to maintain an adequate knowledge base required to provide accurate cursory information or avoid providing inaccurate data to patients at a very sensitive point in time in their care...
December 22, 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28005009/computer-aided-classification-of-gastrointestinal-lesions-in-regular-colonoscopy
#18
Pablo Mesejo, Daniel Pizarro, Armand Abergel, Olivier Rouquette, Sylvain Beorchia, Laurent Poincloux, Adrien Bartoli
We have developed a technique to study how good computers can be at diagnosing gastrointestinal lesions from regular (white light and narrow banded) colonoscopic videos compared to two levels of clinical knowledge (expert and beginner). Our technique includes a novel tissue classification approach which may save clinician's time by avoiding chromoendoscopy, a time-consuming staining procedure using indigo carmine. Our technique also discriminates the severity of individual lesions in patients with many polyps, so that the gastroenterologist can directly focus on those requiring polypectomy...
September 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28004966/a-survey-based-analysis-on-endoscopic-quality-indicators-compliance-among-spanish-endoscopists
#19
Ignacio Fernández-Urien, Federico Argüelles-Arias, Pedro A Alonso-Aguirre, Javier Júdez, Begoña Bermejo
INTRODUCTION: Endoscopy plays a key role for the diagnosis and management of gastrointestinal disorders. Therefore, quality indicators have been widely proposed in order to optimize endoscopic practice. The aims of this study, promoted by the Spanish Society of Digestive Diseases (SEPD), were to assess the knowledge and compliance to endoscopy quality indicators among Spanish gastroenterologists. METHODS: A 31-questionnaire survey was created based on the endoscopy quality indicators proposed by international guidelines...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28002131/premedication-use-before-infliximab-administration-a-cross-sectional-analysis
#20
Joseph Picoraro, Gabriel Winberry, Corey A Siegel, Wael El-Matary, Jonathan Moses, Andrew Grossman, K T Park
BACKGROUND: Premedications are commonly given to patients with inflammatory bowel disease before intravenous infliximab administration. We aimed to (1) describe practice variability; and (2) determine clinician rationale for premedicating patients with inflammatory bowel disease before infliximab administration. METHODS: We developed a cross-sectional electronic survey after comprehensive literature review to assess practice variability and clinician rationale for premedication use before infliximab...
January 2017: Inflammatory Bowel Diseases
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